Montelukast Aurobindo (Montelukast)

Montelukast acts on the leukotriene pathway to control airway inflammation and bronchoconstriction.

• Asthma (maintenance therapy): reduces frequency of symptoms and improves lung function in patients with persistent asthma.
• Allergic rhinitis: alleviates nasal congestion, sneezing and itching associated with seasonal or perennial allergic rhinitis.
• Exercise‑induced bronchoconstriction: prevents narrowing of the airways that can occur during or after physical activity.

• Montelukast selectively blocks the cysteinyl leukotriene receptor CysLT1 on airway smooth‑muscle cells, mast cells and eosinophils. By antagonizing this receptor, it prevents leukotriene‑mediated bronchoconstriction, vascular permeability and inflammatory cell recruitment, thereby reducing airway edema and hyper‑responsiveness associated with asthma and allergic diseases.

Montelukast may be associated with a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Headache: mild to moderate pain often occurring early in therapy.
• Upper respiratory tract infection: symptoms such as sore throat or nasal congestion.
• Abdominal pain: discomfort or cramping in the stomach area.
• Diarrhea: loose stools that may resolve without intervention.
• Cough: occasional dry or productive cough.

Serious or Rare Side Effects

• Allergic reactions: rash, urticaria, or angioedema requiring medical attention.
• Neuropsychiatric events: mood changes, depression, or suicidal thoughts.
• Hepatotoxicity: elevated liver enzymes or hepatitis.
• Stevens‑Johnson syndrome: severe skin blistering and mucosal involvement.
• Anaphylaxis: life‑threatening systemic allergic response.

When prescribing Montelukast, clinicians should consider several safety and handling precautions.

• Indication verification: ensure the drug is appropriate for asthma, allergic rhinitis or exercise‑induced bronchoconstriction.
• Age considerations: use in children only under medical supervision and according to approved pediatric dosing.
• Hepatic function: monitor patients with liver impairment as metabolism occurs hepatically.
• Neuropsychiatric monitoring: observe for mood alterations, depression or suicidal ideation.
• Drug interactions: review concomitant medications for potential interactions.
• Store at ambient temperature: keep tablets in the original container, protect from moisture and excess heat.

Montelukast can interact with other medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Phenobarbital, carbamazepine, phenytoin: strong enzyme inducers that may reduce montelukast plasma concentrations.
• Ritonavir or other potent CYP3A4 inhibitors: may increase exposure and risk of adverse effects.

Moderate Interactions (Monitor Closely)

• Warfarin: possible alteration of anticoagulant effect; monitor INR.
• Fluconazole: moderate CYP3A4 inhibition may raise montelukast levels.
• Salmeterol or other long‑acting β‑agonists: combined use may enhance bronchodilation but requires clinical assessment.
• Antidepressants (e.g., fluoxetine): monitor for neuropsychiatric side effects.